• Hein de Vries, Martijntje Bakker, Patricia Dolan Mullen, and Gerard van Breukelen.
• Department of Health Education, University of Maastricht, P.O. Box 616, 6200 MD Maastricht, The Netherlands. Hein.devries@gvo.unimaas.nl
• Patient Educ Couns. 2006 Oct 1; 63 (1-2): 177-87.

ObjectiveSmoking during pregnancy is an important problem in the Netherlands. We tested the effectiveness of a health counseling method by midwives using a RCT.MethodsFour provinces with 42 practices including 118 midwives were randomly assigned to the experimental or control condition. Midwives in the experimental group provided brief health counseling, self-help materials on smoking cessation during pregnancy and early postpartum, and a partner booklet. Controls received routine care. The main outcome measures were 7-day abstinence, continuous abstinence, and partner smoking at 6 weeks post-intervention (T1) and 6 weeks postpartum (T2).ResultsMulti-level analysis revealed significant differences between both conditions at T1 and T2 using intention-to-treat analysis. Nineteen percent of the experimental group reported 7-day abstinence compared to 7% of the control group at T1, and 21 and 12%, respectively, at T2. For continuous abstinence these percentages were 12% in the experimental group and 3% in the control group. The partner intervention was not successful.ConclusionThe intervention resulted in significant effects on smoking behavior for pregnant women, but not for partner smoking.Practice ImplicationsThe program realized short-term effects. An important precondition is that midwives need a proper training.

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